White Ted, Burns Bracken, Leonard Matthew, Nwabueze Christian, Quinn Megan
Trauma, Ballad Health Medical Group, Johnson City, USA.
Surgery, Quillen College of Medicine, East Tennessee State University, Johnson City, USA.
Cureus. 2020 Mar 14;12(3):e7266. doi: 10.7759/cureus.7266.
This was a retrospective study that aimed to determine the treatment outcome of patients seen in the trauma unit of the Johnson City Medical Center (JCMC). The study included 2844 patients in the trauma registry and evaluated age, sex, injury severity score (ISS), length of stay (LOS) in the intensive care unit (ICU), overall hospital lengths of stay (LOS), ventilator days, discharge disposition, and complications between one group managed by extenders only and the second managed by both residents and extenders. The sample size of the two groups was similar (group one = 1446 and group two = 1398) and the proportions of males and females in the two groups were identical (males = 65%, females = 35%). Both groups had similar mechanisms of injury, although group one had a higher percentage of falls (32.9% vs. 22.03%) and group two had a higher proportion of motor vehicle crash (MVC) traumas (40.41% vs 30%). There was no significant difference in those discharged home and deaths between the two groups. (χ(1, N = 2258) = 0.04, p = 0.82). Complications showed statistical significance when looking at extenders vs. residents plus extenders for all complications (χ(7, N = 196) = 38.73, p ≤ 0.0001). It is possible that having extenders only versus both extenders and residents had no significant difference among the patient outcomes based on the variables age, sex, ISS, ICU days, overall hospital LOS, and ventilator days; however, when observing complications between the two groups, it is possible that patients are more likely to have complications due to overall hospital LOS in the residents plus extenders group.
这是一项回顾性研究，旨在确定在约翰逊市医疗中心（JCMC）创伤科就诊患者的治疗结果。该研究纳入了创伤登记处的2844名患者，并评估了年龄、性别、损伤严重程度评分（ISS）、重症监护病房（ICU）住院时间（LOS）、总体住院时间（LOS）、呼吸机使用天数、出院处置情况，以及仅由助理医师管理的一组与由住院医师和助理医师共同管理的另一组之间的并发症情况。两组的样本量相似（第一组 = 1446，第二组 = 1398），且两组中男性和女性的比例相同（男性 = 65%，女性 = 35%）。两组的损伤机制相似，尽管第一组跌倒的比例较高（32.9% 对 22.03%），第二组机动车碰撞（MVC）创伤的比例较高（40.41% 对 30%）。两组之间出院回家和死亡的情况没有显著差异（χ(1, N = 2258) = 0.04，p = 0.82）。在观察所有并发症时，比较助理医师与住院医师加助理医师，并发症显示出统计学意义（χ(7, N = 196) = 38.73，p ≤ 0.0001）。基于年龄、性别、ISS、ICU住院天数、总体住院LOS和呼吸机使用天数等变量，仅有助理医师与助理医师和住院医师同时存在可能在患者治疗结果方面没有显著差异；然而，当观察两组之间的并发症时，住院医师加助理医师组的患者可能由于总体住院LOS而更易出现并发症。
